With the best of intentions, foundations and nonprofit organizations often design and support programs based on what they think the people they serve need and want. But in the end, they discover they have designed solutions that miss the mark—their programs aren’t used, and they don’t get the outcomes that they expected.

So at the Health Foundation for Western and Central New York, we wanted to find out what was possible when we created solutions with people, rather than for them.

That’s why we launched Aging by Design, a multiyear initiative to improve the health of older adults, which uses a process called Design Thinking.

Design Thinking is an approach to solving complex problems that puts the needs of the people experiencing a problem at the core. It allows us to consider the experiences and perspectives of older adults in the communities we serve, generate and test ideas to meet their needs, and then implement innovative and practical solutions.

From some of the Health Foundation’s previous work and research around the needs of older adults, particularly those who are frail, we learned that developing programs and interventions that reach this group of people can be challenging, to say the least. For example, many solutions are designed under the assumption that older adults can get to a location in their communities. Or there is the assumption of literacy, motivation, or cultural fit, without really knowing if people can read, are motivated, or share that culture.

So Aging by Design aims to spur creativity and innovation by supporting organizations that serve older adults and caregivers in designing, testing, and implementing new or re-imagined approaches to reducing Triggers of Decline such as falls, medication errors, and lack of services for caregivers caring for older adults.

Aging by Design is not like one of our typical programs. In fact, using Design Thinking is a brand-new approach for our foundation. So to kick things off, we didn’t ask for a traditional application for funding or send out a request for proposals. What we did first was ask organizations to come to a “Design Day” workshop to learn all about Design Thinking and how to apply it.

We did this because, like us, many organizations using Design Thinking find it a significant departure from how they normally operate. Organizations have to be willing to engage in a human-centered design process with older adults and caregivers without knowing exactly where they’ll all end up. It is about engaging in a process rather than delivering a predetermined outcome. This approach is not for everyone.

But for those that were willing to try something new and get involved, the next step after Design Day focused on one thing—hearing directly from the older adults whom our partner organizations and agencies interact with on a daily basis.

Using a variety of methods, including empathy maps, journals, stakeholder labs, and street teams, our partners asked older adults and caregivers about everyday experiences and memorable moments to get a better insight into their needs.

What We Heard

In responding to questions like “What makes you feel like you are part of a community?” the voices of hundreds of older adults from across western and central New York—our friends, neighbors, parents, and clients—leapt off the pages (of the empathy maps and journals) to tell us what they actually need, not just what they want.

We found that while many older adults grapple with the day-to-day challenges that we all encounter as we get older, many others face barriers that come with living in communities that were often built by and for younger people.

Themes emerged around these needs. Some confirmed what we already knew, such as “I need accessible transportation,” and “I need to understand my loved one’s medical issues.”

Others offered some surprising insights. “I need to maintain my sense of humor” suggests that maybe we need to look at how we can incorporate some light-heartedness into programs. We also heard, “I need normal conversation,” instead of someone talking at them, and “I need to be around friendly people,” which is a gentle reminder that at the end of the day, older adults are just people who want to be treated nicely, as we all do.


Moving forward into the next phase of Aging by Design, our selected grantee partners will now learn how to apply design thinking to re-imagine how they might address identified needs and reduce triggers of decline among older adults.

With each new step, we gain a better, more holistic understanding of our community and the older people living in it.

After less than a year, we’re seeing that Aging by Design is already helping our partners incorporate design thinking into their work with older adults. Some organizations have also found that they are not only bringing new perspectives into their own groups, but also bringing new views to other people and groups that work with the same people. Those organizations can use it to inform the work they do.

Aging by Design is starting conversations that will bring new understanding and a human-centered focus to the way we provide care and support to people as they age.

Older adults are too often seen for the problems they have, rather than the wisdom they have to share. Through Aging by Design, the Health Foundation’s goal is to benefit from the experience of today’s older adults. The foundation is working with organizations collaborating with older adults to shape the future of services that will not only support them, but all of us as we age.